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General NPI Number Information
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NPI Number | 1104975986
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Entity Type | Organization
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Legal Business Name | NEWBURGH EYE ASSOCIATES PHYSICIANS & SURGEONS, PC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 313 FULLERTON AVE
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City | NEWBURGH
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State | NY
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Zip | 12550-3723
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Country | US
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Telephone | 845-561-4274
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Fax | 845-561-6665
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Provider Business Mailing Address
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Address Line | 313 FULLERTON AVE
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City | NEWBURGH
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State | NY
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Zip | 12550-3723
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Country | US
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Telephone | 845-561-4274
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Fax | 845-561-6665
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID ALAN GOLDFARB
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Credential | M.D.
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Telephone | 845-561-4274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 124684-1
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License Number State | NY
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